中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
23期
39-41
,共3页
李付彬%朱台航%徐向峰%李杰峰%金艳南%王庆东
李付彬%硃檯航%徐嚮峰%李傑峰%金豔南%王慶東
리부빈%주태항%서향봉%리걸봉%금염남%왕경동
类风湿性关节炎%膝外翻%全膝关节置换术
類風濕性關節炎%膝外翻%全膝關節置換術
류풍습성관절염%슬외번%전슬관절치환술
Rheumatoid arthritis%Valgus knee%Total knee arthroplasty
目的 探讨全膝关节置换术治疗重症类风湿性关节炎伴外翻畸形的手术方法和临床疗效.方法 选择2006年7月至2010年8月收治的15例(18膝)类风湿性关节炎伴膝外翻畸形患者,术前X线测量FTA角和膝关节活动度,使用美国膝关节协会评价标准、KSS评分及功能评分.手术方法采用髌旁外侧入路、针对性截骨及外侧软组织松解行全膝关节置换术.术后测量FTA角,随访中用KSS评分及功能评分来评价手术效果.结果 术后平均随访时间17.4个月(7～36个月),无感染患者.所有膝关节术后外翻畸形基本得到矫正,FAT角平均为4.7°(O°～12°),较术前18.0°(10°～35°)有明显改善.膝关节活动度由术前的79.4°(70°～90°)提高到106.9°(100°～130°)；KSS评分由术前的28.7分(15～40分)提高到87.8分(85 ～ 95分),功能评分由术前的24.0分(0～40分)提高到90.2分(85～95分),差异均有统计学意义(P＜0.01).结论 采用髌旁外侧入路、针对性截骨、合理的外侧软组织松解和后稳定型假体实施人工全膝关节置换术治疗重症类风湿性关节炎伴外翻畸形可以取得满意的临床效果.
目的 探討全膝關節置換術治療重癥類風濕性關節炎伴外翻畸形的手術方法和臨床療效.方法 選擇2006年7月至2010年8月收治的15例(18膝)類風濕性關節炎伴膝外翻畸形患者,術前X線測量FTA角和膝關節活動度,使用美國膝關節協會評價標準、KSS評分及功能評分.手術方法採用髕徬外側入路、針對性截骨及外側軟組織鬆解行全膝關節置換術.術後測量FTA角,隨訪中用KSS評分及功能評分來評價手術效果.結果 術後平均隨訪時間17.4箇月(7～36箇月),無感染患者.所有膝關節術後外翻畸形基本得到矯正,FAT角平均為4.7°(O°～12°),較術前18.0°(10°～35°)有明顯改善.膝關節活動度由術前的79.4°(70°～90°)提高到106.9°(100°～130°)；KSS評分由術前的28.7分(15～40分)提高到87.8分(85 ～ 95分),功能評分由術前的24.0分(0～40分)提高到90.2分(85～95分),差異均有統計學意義(P＜0.01).結論 採用髕徬外側入路、針對性截骨、閤理的外側軟組織鬆解和後穩定型假體實施人工全膝關節置換術治療重癥類風濕性關節炎伴外翻畸形可以取得滿意的臨床效果.
목적 탐토전슬관절치환술치료중증류풍습성관절염반외번기형적수술방법화림상료효.방법 선택2006년7월지2010년8월수치적15례(18슬)류풍습성관절염반슬외번기형환자,술전X선측량FTA각화슬관절활동도,사용미국슬관절협회평개표준、KSS평분급공능평분.수술방법채용빈방외측입로、침대성절골급외측연조직송해행전슬관절치환술.술후측량FTA각,수방중용KSS평분급공능평분래평개수술효과.결과 술후평균수방시간17.4개월(7～36개월),무감염환자.소유슬관절술후외번기형기본득도교정,FAT각평균위4.7°(O°～12°),교술전18.0°(10°～35°)유명현개선.슬관절활동도유술전적79.4°(70°～90°)제고도106.9°(100°～130°)；KSS평분유술전적28.7분(15～40분)제고도87.8분(85 ～ 95분),공능평분유술전적24.0분(0～40분)제고도90.2분(85～95분),차이균유통계학의의(P＜0.01).결론 채용빈방외측입로、침대성절골、합리적외측연조직송해화후은정형가체실시인공전슬관절치환술치료중증류풍습성관절염반외번기형가이취득만의적림상효과.
Objective To investigate the clinical efficacy and surgical methods of the total knee arthroplasty (TKA) for the patients of rheumatoid arthritis with valgus knee deformity.Methods During July 2006 to August 2010 in the second affiliated hospital of Luohe Medical College,fifteen patients(18 knees) were treated with TKA.To measure the FTA angles,the ROM of the knee joint,KSS and function scores before operation,then patellar lateral approach,targeted osteotomy,selective lateral soft tissue release and posterior stabilized implants were selected to complete the operation.After the operation,the above-mentioned criteria were remeasured in order to compare the effect of surgery with preoperative.Results All patients were followed up for 7 to 36 months.FTA angles reduced from preoperative 18.0° (10°-35°) to 4.7° (0°-12°).The ROM increased from preoperative 79.4° (70°-90°) to 106.9° (100 °-130 °).KSS score improved from 28.7 points (15-40 points) to 87.8 points (85-95 points),functional score improved from 24.0 points(0-40 points) to 90.2 points(85-95 points).The differences were statistical significance (P ＜ 0.01).Conclusions Patellar side lateral approach,targeted osteotomy,selective lateral soft tissue release,posterior stabilized implants of TKA,can achieve satisfactory the clinical effect.
